Skip to main content

Empowerment: A goal or a means for health promotion?


Empowerment is a concept that has been much used and discussed for a number of years. However, it is not always explicitly clarified what its central meaning is. The present paper intends to clarify what empowerment means, and relate it to the goals of health promotion. The paper starts with the claim that health-related quality of life is the ultimate general goal for health promotion, and continues by briefly presenting definitions of some central concepts: “welfare” “health” and “quality of life”. Several suggestions as to what empowerment is are then discussed: autonomy, freedom, knowledge, self-esteem, self-confidence, and control over health or life. One conclusion of this discussion is that empowerment can be seen as a complex goal which includes aspects of the three central concepts welfare, health and quality of life. To the extent that the empowerment goals aimed at are health-related, it is concluded that empowerment is a legitimate goal for health promotion. But empowerment is not only a goal, it can also be described as a process or as an approach. This process, or approach, in a fundamental way involves the participants in problem formulation, decision making and action, which means that the experts have to relinquish some of their control and power.

This is a preview of subscription content, access via your institution.


  • Bandura A. (1982). Self-Efficacy Mechanism in Human Agency. American Psychologist 37(2):122–147

    Article  Google Scholar 

  • Boorse C. (1977). Health as a Theoretical Concept. Philosophy of Science 44:542–573

    Article  Google Scholar 

  • Brülde, B.: 1998, The Human Good [dissertation]. Göteborg, Acta Universitatis Gothoburgensis

  • Brülde B. (2000a). On How to Define the Concept of Health: A Loose Comparative Approach. Medicine, Health Care and Philosophy 3:305–308

    Google Scholar 

  • Brülde B. (2000b). More on the Looser Comparative Approach to Defining ’Health’: A Reply to Nordenfelt’s Reply. Medicine, Health Care and Philosophy 3:313–315

    Google Scholar 

  • Bru¨lde, B. and P.-A. Tengland: 2003, Ha¨lsa och Sjukdom En begreppsling utredning. Lund: Studentlitteratur

  • Culver C.M., Gert B. (1982). Philosophy in Medicine. Oxford, Oxford, U P

    Google Scholar 

  • Dworkin G. (1988). The Theory and Practice of Autonomy. Cambridge, Cambridge University Press

    Google Scholar 

  • Eklund, L.: 1999, From Citizen Participation Towards Community Empowerment. Academic Dissertation, University of Tampere Tampere

  • Freire P. (1970). Pedagogy of the Oppressed. New York, Continuum

    Google Scholar 

  • Gibson C. (1991). A Concept Analysis of Empowerment. Journal of Advanced Nursing 16:354–361

    Article  Google Scholar 

  • Laverack G. (2004). Health Promotion Practice. Power and Empowerment. London, Sage

    Google Scholar 

  • Naryan, D. (ed.): 2002, Empowerment and Poverty Reduction: A Sourcebook. Washington: The World Bank

  • Nordenfelt L. (1993). Quality of Life, Health and Happiness. Aldershot, Avebury Press

    Google Scholar 

  • Nordenfelt L. (1995). On the Nature of Health. Dordrecht, Reidel

    Google Scholar 

  • Parfit D. (1984). Reasons and Persons. Oxford, Clarendon Press

    Google Scholar 

  • Pörn, I.: 1984, ‘An Equilibrium Model of Health’, in: I.␣Lindahl, and Nordenfelt, L. (eds.), Health, Disease and Causal Explanations in Medicine. Dordrecht: Reidel, pp. 3–9

  • Raeburn J., Rootman I. (1998). People-Centered Health Promotion. Chichester, Wiley

    Google Scholar 

  • Rappaport, J.: 1981, ‘In Praise of a Paradox: A Social Policy of Empowerment over Prevention’, American Journal of Community Psychology 9(1), 1–25

    Google Scholar 

  • Rappaport J. (1985). The Power of Empowerment Language. Social Policy 16, 215–221

    Google Scholar 

  • Rissel C. (1994). Empowerment: The Holy Grail of Health Promotion? Health Promotion International 9(1):39–47

    Article  Google Scholar 

  • Rodwell C. (1996). An Analysis of the Concept of Empowerment. Journal of Advanced Nursing 23:305–313

    Article  CAS  PubMed  Google Scholar 

  • Rogers C. (1951). Client-centered Therapy. Boston, Houghton Mifflin

    Google Scholar 

  • Rogers C. (1961). On Becoming a Person. Boston, Houghton Mifflin

    Google Scholar 

  • Rogers C. (1977). The Person-centered Approach and the Oppressed. In: Rogers C. (eds), Carl Rogers on Personal Power. New York, Delacorte, pp. 105–114

    Google Scholar 

  • Ryle, G.: 1971, ‘Knowing that and Knowing How’, in: Collected papers, Vol. II Collected Essays 1929–1968. New York: Barnes & Noble

  • Sen A. (1999). Development as Freedom. Oxford, Oxford University Press

    Google Scholar 

  • Swift, C. and G. Levin: 1987, ‘Empowerment: An Emerging Mental Health Technology’, Journal of Primary Prevention 8(1&2), 71–94

    Google Scholar 

  • Tengland, P.-A.: 2001, Mental Health: A Philosophical Analysis. Dordrecht: Kluwer Academic Publishers

  • Tengland, P.-A.: 2006, `Medicine: Health Care and Philosophy’, The goals of Health Work quality of life, Health and Welfare (2006) 9: 155–167

  • Tones K. (1997). Health Promotion: Empowering Choice. In: Myers L., Midence K. (eds), Adherence to Treatment in Medical Conditions. London, Harewood Academic Publishers, pp. 133–160

    Google Scholar 

  • Vickridge R., Ayub R. (2003). Participation and Empowerment. In: MacDonald T.H. (eds), The Social Significance of Health Promotion. London, Routledge, pp. 43–65

    Google Scholar 

  • Wallerstein, N.: 1992, ‘Powerlessness, Empowerment and Health: Implications for Health Promotion Programs’, Behavior change 6(3), 197–205

  • Wallerstein N., Bernstein E. (1988). Empowerment Education: Freire’s Ideas Adapted to Health Education. Health Education Quarterly 15(4):379–394

    CAS  PubMed  Google Scholar 

  • WHO: 1948, Official Records of the World Health Organization, 2, 100

  • WHO (1986). Ottawa Charter for Health Promotion. WHO, Geneva

    Google Scholar 

  • WHO (1998). Health Promotion Glossary. WHO, Geneva

    Google Scholar 

  • Zimmerman M.A., Rappaport J. (1988). Citizens Participation, Perceived Control and Psychological Empowerment. American Journal of Community Psychology 16:725–750

    Article  CAS  PubMed  Google Scholar 

Download references


I would like to thank Bengt Brülde, Lennart Nordenfelt and two anonymous reviewers for valuable comments on earlier versions of this text.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Per-Anders Tengland.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tengland, PA. Empowerment: A goal or a means for health promotion?. Med Health Care Philos 10, 197 (2007).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI:


  • autonomy
  • control
  • empowerment
  • freedom
  • health
  • health promotion
  • health-related quality of life
  • process
  • quality of life
  • self-esteem
  • welfare